PURPOSE: The study objective was to investigate whether semen quality or some easily attainable clinical parameters might be used to estimate the risk of contralateral carcinoma-in-situ (CIS) in patients with unilateral testicular germ-cell tumours (TGCT).
MATERIALS AND METHODS: 264 Danish TGCT patients with or without contralateral CIS testis were retrospectively investigated. Clinical data included andrological history, physical examination, testis ultrasonography, semen quality and testis histology. Study groups were compared by univariate linear regression analysis and Chi-square test. Associations between contralateral CIS and risk factors were modeled in two stages: Bayes rule was used to assess the probability of CIS; the terms in Bayes rule were estimated using regression models.
RESULTS: Significant characteristics of patients with contralateral CIS ( N =46) were lower sperm concentration, smaller contralateral testis volume, irregular ultrasonic echo pattern of the contralateral testis and younger age. Cut-off values of sperm concentration and testicular volume were defined. However, according to these only a minority of the non-CIS patients could potentially have been spared a diagnostic testicular biopsy. Combining information on age and sperm concentration, secondly age and testis volume resulted in models of the estimated contralateral CIS risk, from which patients at particular high risk of CIS could be identified.
CONCLUSION: The combined information on sperm concentration, age and contralateral testis volume predict the risk of contralateral CIS in patients with unilateral TGCT. The proposed models may facilitate selection of TGCT patients for contralateral testicular biopsy at the time of orchiectomy if this is not routinely done.
Written by:
Rud CN, Daugaard G, Rajpert-De Meyts E, Skakkebæk NE, Petersen JH, Jørgensen N. Are you the author?
University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; University Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
Reference: J Urol. 2013 Jun 13. pii: S0022-5347(13)04611-9.
doi: 10.1016/j.juro.2013.06.023
PubMed Abstract
PMID: 23770148
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